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Again with the fosters!

It has already been the catalyst for one cat developing
fatty liver disease which was completely and totally avoidable. If you
can't monitor the foster cats, you shouldn't take them in. If the cat is
diagnosed with Fatty Liver Disease, I hope you take responsibility for
what happened, give it whatever care it needs and bring it back to
health.

Contrary to your assumption, the cat came to me with a history of refusal to
eat. His liver disease had absolutely nothing to do with the free-feeding
that satisfies the rest of my cats, fosters and owned alike.

As for his diagnosis? Beyond it being a liver problem, and quite severe,
nothing further came of it. The staff vet, when asked for her honest
opinion, said that fatty liver would be the best-case scenario, require
months of rehabilitation, and the only way to know if it even was fatty
liver would be a biopsy, which would require surgery, which he wouldn't be
likely to wake from. So I made the call, and held him while he was put
down.

I won't assume that you'll take twisted satisfaction and claim again that it
was my fault, but I'll be more than happy to imply it.

| As for his diagnosis? Beyond it being a liver problem, and quite severe,
| nothing further came of it.

What were the numbers? Was he being hydrated besides being force-fed?
Did the radiographs you wrote about show anything abnormal?

I don't know the numbers.
He was being forcefed watery, warm a/d. His hydration was good until a
couple of days before I took him in.
The radiographs were never taken. The vet didn't believe they would show us
anything new.

| The staff vet, when asked for her honest opinion,

Was this the same staff vet who told you that declawing doesn't involve
amputation?

No.

| said that fatty liver would be the best-case scenario, require months of
| rehabilitation,

It varies, but yes, recovery is far from overnight. However, hepatic
lipidosis is *very* treatable if caught early enough.

I'm assuming hepatic lipidosis is the same thing as fatty liver disease.
Realize that perhaps you're a vet, or a vet tech, or you're just very well
educated, but any technical terms I know are ones I've picked up, and as I'm
generally just a lowly cage-cleaner, I don't exactly hang out with the techs
and vets.

| and the only way to know if it even was fatty liver would be a biopsy,
| which would require surgery, which he wouldn't be likely to wake from.

In other words, the radiographs showed nothing, the bloodwork showed
elevated liver values, the cat had stopped eating, the cat showed signs
of jaundice, and HL was *not* a probable diagnosis?

Even the techs realized that he was in trouble, just looking at the test
results performed in lab. The cat was yellow. The insides of his ears had
gone yellow. His third eyelids were yellowed.
Because of his medical history (as I said), the vet said that fatty liver
disease would be the best-case diagnosis. It might have been impending liver
failure completely, for all I know.

| So I made the call, and held him while he was put down.

In other words, pulling the cat out of hepatic lipidosis would have been
too much hassle.

For a shelter with unlimited funds, perhaps they would have treated him in
an intensive care unit and tube fed him for however long it took to get him
better. Perhaps they could have risked a surgery he might not have survived.
We're not a shelter with unlimited funds.
I went with what I was being told. People with much more experience in
making judgement calls on this sort of thing told me what they would do in
my shoes, what would be best for a suffering cat, and I chose to end his
suffering. I chose to follow their experience.
Feel free to continue thinking I gave him up without the slightest remorse.

| What were the numbers? Was he being hydrated besides being force-fed?
| Did the radiographs you wrote about show anything abnormal?
|
| I don't know the numbers. He was being forcefed watery, warm a/d. His
| hydration was good until a couple of days before I took him in.

I meant whether he was being given subQ fluids (or even IV). It's a
common treatment for cats with poor appetite and in poorish condition.

| The radiographs were never taken. The vet didn't believe they would show
| us anything new.

But that means they knew what was wrong with him, doesn't it?

| However, hepatic lipidosis is *very* treatable if caught early enough.
|
| I'm assuming hepatic lipidosis is the same thing as fatty liver disease.

Yes. Hepatic means liver-related (just as renal means kidney-related),
and lipids are fats. A definitive diagnosis of HL by biopsy is when the
sample taken shows fat buildup among the liuer cells. The condition is
idiopathic (meaning that definite, specific causes are not known), and
often associated with other liver conditions, such as jaundice. The
giveaway for incipient HL is poor appetite - when the cat suddenly stops
eating completely, that's the classic onset.

It's a nasty condition in that getting the cat to eat again is a tedious
process. Usually forcefeeding isn't enough. Instead, a tube is placed
directly into the stomach and you start off by pumping food in every 3-4
hours or so, like feeding small kittens. Over time the frequency of
feeding can be tapered off, and eventually the cat will start to eat by
itself again. From this you can see that it's clearly preferable to
*prevent* HL.

| In other words, the radiographs showed nothing, the bloodwork showed
| elevated liver values, the cat had stopped eating, the cat showed signs
| of jaundice, and HL was *not* a probable diagnosis?
|
| Even the techs realized that he was in trouble, just looking at the test
| results performed in lab. The cat was yellow. The insides of his ears had
| gone yellow. His third eyelids were yellowed.
| Because of his medical history (as I said), the vet said that fatty liver
| disease would be the best-case diagnosis.

I'm sorry, but this isn't adding up. The cat was *clearly* jaundiced
already. It really sounds like the vets were simply waiting for HL to
show up as the inevitable complication! In other words, he was already
a serious medical case *before* the clear onset of HL.

And they dumped this guy on you as if he were an ordinary foster?!?

| It might have been impending liver failure completely, for all I know.

True enough. HL would simply have been the coup de grace to finish the
poor fellow off.

| I went with what I was being told. People with much more experience in
| making judgement calls on this sort of thing told me what they would do
| in my shoes, what would be best for a suffering cat, and I chose to end
| his suffering. I chose to follow their experience.

I don't get it. Why were you left holding the bag here? They had a
medical case, and you were supposed to decide what to do? I'm amazed -
and more than a little dismayed - that they didn't clue you in to the
gravity of his condition, the need for strict monitoring and possibly
for extraordinary effort in the short run to pull him through.

I think you can save yourself a lot of heartache in the future by making
it clear to these shelter folks that you'd rather have ordinary fosters
to look after rather than serious medical cases.

| The radiographs were never taken. The vet didn't believe they would show
| us anything new.

But that means they knew what was wrong with him, doesn't it?

(Damned Outlook Express keeps shutting down on me, so I apologize if any of
this comes off short-tempered or irritated.)

From his bloodwork and appearance, all they knew was it was something severe
and liver-related.
| Even the techs realized that he was in trouble, just looking at the test
| results performed in lab. The cat was yellow. The insides of his ears
had
| gone yellow. His third eyelids were yellowed.
| Because of his medical history (as I said), the vet said that fatty
liver
| disease would be the best-case diagnosis.

I'm sorry, but this isn't adding up. The cat was *clearly* jaundiced
already. It really sounds like the vets were simply waiting for HL to
show up as the inevitable complication! In other words, he was already
a serious medical case *before* the clear onset of HL.

And they dumped this guy on you as if he were an ordinary foster?!?

No. He was a surrendered cat who may have had a condition coming into the
shelter. If the owner didn't tell us, we don't know. He spent three weeks in
the isolation room for URI and refusal to eat. When I -offered- to take him,
rather than see him put down, that's all they knew it was. He showed no
signs of anything else. I imagine if bloodwork had been done and elevated
liver values returned, and the vet had considered liver malfunction, my
request to foster him would have been denied.
| I went with what I was being told. People with much more experience in
| making judgement calls on this sort of thing told me what they would do
| in my shoes, what would be best for a suffering cat, and I chose to end
| his suffering. I chose to follow their experience.

I don't get it. Why were you left holding the bag here? They had a
medical case, and you were supposed to decide what to do?

The vet said she prefers to have the input of the foster parent, simply
because there's a greater attachment to an animal you've been housing and
feeding and taking care of for any length of time. The vet gave me her
opinion, and she said that if I didn't feel comfortable making the call, she
would do so. I chose to let him go peacefully, and he did go very quickly.
He had no fight left in him, which is what tells me it was the right choice.

I'm amazed -
and more than a little dismayed - that they didn't clue you in to the
gravity of his condition, the need for strict monitoring and possibly
for extraordinary effort in the short run to pull him through.

As I said, when they let me take him, it was nothing more than chronic URI
and refusal to eat. Shelters see a lot of cats that stop eating for a
variety of reasons, and suffer from depression to boot. The hope was that a
home environment would help. It helped with the URI, which cleared up in
days, with not even a sneeze after two weeks. He ate enough on his own to
make stool, but not quite maintain his weight. It was only in the last
couple of days that he got bad. "Crashed," as it were. I notified the vet
and got him in as soon as she could meet me, and by then he had gone yellow
and started vomiting up whatever I forcefed him.

I think you can save yourself a lot of heartache in the future by making
it clear to these shelter folks that you'd rather have ordinary fosters
to look after rather than serious medical cases.

I don't have the experience necessary to look after medical cases beyond
URI, but I have a knack for getting depressed cats up and about and eating
well again. Those are the ones I tend to take, because those are the ones
that will end up getting seriously ill if they continue to starve
themselves.

I do need to apologize for being snippy, Arjun. I attach very quickly to
cats especially, and I was particularly offended by Megan's assumption that
I caused his condition and the implication that putting him down was an easy
thing to do. I broke down just telling my supervisor what was happening. I
sort of took some of that excess of emotion out on you.